To compare the efficacy of an analgesic effect of 0.25% bupivacaine and 0.25% bupivacaine plus dexamethasone 8mg in post operative transverse abdominis plane block in patient undergoing lower abdomen surgeries

Objective: To compare the efficacy of an Analgesic Effect of 0.25% Bupivacaine and 0.25% Bupivacaine Plus Dexamethasone 8mg in Post Operative Transverse Abdominis Plane Block in Patient Undergoing Lower Abdomen Surgeries
Background: Postoperative analgesia is vital after lower abdominal surgery as it facilitates early ambulation, recovery rate and overall patient satisfaction. Our study pioneers the use of TAP block for postoperative analgesia thus positively influencing patient's outcome following lower abdominal surgeries.
Method: Prospective randomised prospective study, patients undergoing lower abdominal surgery were randomised into 2 groups to receive PNS guided TAP block, Group A- TAP block with 0.25% Bupivacaine (20ml), Group B with 20ml 0.25% Bupivacaine plus 8mg(2ml) Dexamethasone. The primary objective was to compare duration of analgesia. Secondary objectives were to compare the total number of rescue analgesia doses required with visual analogue scale (VAS) score up to 24 hours postoperatively. Data was compared using the Standard deviation, Pearson’s chi-square test and paired t-test. Results: Duration of analgesia was higher in the Group B than Group A (mean±SD: 1494 ± 88.11 minutes vs 864 ± 61.19 minutes)(P < 0.05). Number of rescue analgesia requirement was less in group B (1.27 ± 0.44 doses, mean ± SD) than group A (3.40 ± 0.49 doses). VAS score was much lesser in Group B than Group A at 12 hrs,16 hrs, 20 hrs and 24 hrs. Conclusion: Group B patients showed significantly prolonged and effective analgesia than Group A. Reason being addition of an additive dexamethasone in group B that has potentiated the action of local anaesthetic through their anti-inflamatory and immunosuppressive effects.